Payesh
Year:2013 | Volume:12 | Issue:5|Papers Count:15

Objective (s): To determine technical efficiency and its relationship with environmental factors using data envelopment analysis (DEA) in selected hospitals through 2006-2008.Methods: The number of active beds and human resources were used as input variables and bed occupancy and outpatient visits were used as outputs. Applying variable return to scale (VRS), the value of technical, managerial and scale efficiency were calculated. The over-utilization of inputs was measured using the estimation of slacks and radial movements. The DEAP-2 was used to measure the efficiency.Results: Over the study period, the mean technical, managerial and scale efficiencies were 0.88, 0.934 and 0.936, respectively. There were 17.66% and 18.72% over-utilization of active beds and human resources during the study period. There was significant association between technical efficiency and type of activity and ownership of hospitals. The results of ANOVA showed that the technical efficiency did not change significantly through 2006-2008.Conclusion: The results showed that there were inefficiencies in hospitals’ performance and it is possible to produce the same outputs with decreasead inputs. Moreover, it seems that environmental factors affect the hospital performance.

Objective (s): With regard to the increase use of acupuncture for pain relief in Iran, until now, there is no structured review of the existing scientific documents. The aim of this study was to provide a meta analysis of evidence on effectiveness of acupuncture in pain relief in Iran.Methods: Using several databases seven studies were identified and included in this meta analysis. We included studies if the study was experimental, and the primary outcome was pain relief. Then the data were analyzed performing convential analysis using CMA statistical software.Results: In all data for 436 individuals were available for analysis (218 cases and 218 controls). The longest intervention time was 3 months with 9 sessions and the least was 15 minutes. Among 7 studies, 5 studies showed that acupuncture had a significant effect on pain relief. The result of integration of data indicated the effect size value -1.310 (95% CI = -0.535 to -2.085 (P < 0.001).Conclusion: The findings from this analysis indicated that acupuncture was effective in pain relief.

Objective (s): HIV/AIDS transmission via sexual intercourse among women is increasing and becoming as a serious concern. Studies suggest that social support might play a role in preventing HIV related sexual behaviors. We aimed to explore the perceptions and experiences of women at risk for HIV about social support.Methods: A grounded theory methods was used for analyzing the participants' experiences and their perceptions. Twenty eight semi structured in-depth interviews were conducted with 25 women at risk of HIV/AIDS, aged 21-49 years, by purposeful sampling at voluntary counseling and testing centers or a NGO Drop in Centers (DIC) in Tehran, Iran. Qualitative analysis of the data was conducted manually and was guided by constant comparative analysis.Results: Results showed that social support was the essential concept for the women in term of their ability to protect themselves against HIV/AIDS. Love and family support, employment, finantial support and informational needs appeard as some components of social support.Conclusion: This qualitative study demonstrated the importance of considering social support from different sources for women at risk of HIV.

Objective (s): This study aimed to investigate the quality of life in older people suffering from abuse by family members in comparison with older patients without such experiences.Methods: Using a quantitative design and a cross-sectional approach, 360 older people (180 abused and 180 non- abused older people) aged over 65 years was entered into the study. Data were collected using the Iranian version of Abbreviated Mental Test Score, the Domestic Elder Abuse Questionnaire and the Iranian version of 36-item Short form Health Survey (SF-36) via face-to-face interviews.Results: It was found that the older people who did not experience abuse from family members reported higher quality of life in comparison with the abused older people(P<0.00001). Significant differences were observed between male and female with regard to health-related quality of life (P<0.00001).Conclusion: The findings suggest that detecting the symptoms of abuse in older people is importantIndeed providing preventive and supportive care for this population seems necessary.

Objective (s): Diabetes is one of the most common metabolic syndromes with debilitating complication, and chronic course. Chronic complications of diabetes and its potential costs are often causing of financial loss and decrease of quality of life. This study aimed to assess quality of life and its dimensions in patients with type II diabetes.Methods: This was a cross-sectional study of 224 patients with Type II diabetes referred to the Endocrinology and Metabolism Institute of Iran University of Medical Sciences. Data were collected on demographic and quality of life including information on 5 dimensions (physical, psychological, social, economic and disease and treatment).Results: The results showed that the physical quality of life in 53.3 percent of sample was more than average score. Also 63.4% of the patients scored higher than mean score on psychological dimension. This figure for social, economic and disease and treatment related dimensions were 65.4%, 51.8% and 51.4% respectively. Quality of life significantly was associated with age, gender, educational level, economic status and complications.Conclusion: The findings confirmed that quality of life in diabetic patients was associated with demographic factors. Indeed in order to better manage patients subgroup of patients should be considered.

Objective (s): War is an event that causes physical and psychological disorders. One of these complications is blindness that may occur in one or two eyes. The blindness may affect the adjustment state of warfare veterans. This study aimed to investigate the emotional and social adjustment among warfare veterans with blindness.Methods: This study was a cross-sectional study of 45 warfare veterans in Zanjan, Iran. Participants were suffering from one eye blindness. Data was collected by the Bell Adjustment inventory. We used SPSS software to analyze the data performing one-way analysis of variance.Results: The mean age of veterans was 48±7 years. The results showed that 53.4% of the sample had poor emotional adjustment. With regard to social adjustment 44.4% of the sample had fair and 44.4% had moderate adjustment. There was a meaningful difference between social adjustment and age (p=0.017). Also there was a meaningful difference in mean emotional adjustment scores among veterans (p=0.022). However, there were no differences in mean emotional and social adjustment scores with marital status, education, exercise and reason of injury.Conclusion: The findings indicated that many veterans with eye blindness suffer from poor emotional and social adjustment. Indeed further attention to this population and their needs are recommended.

Objective (s): The Islamic Republic of Iran has experienced a dramatic decrease in fertility rates in the past three decades. Despite extensive research in the field of demography and fertility, many previous studies have been conducted based on quantitative methods and frequently criticized especially in the micro level. Since the qualitative research will provide a much deeper understanding of the decision-making processes, this study was conducted to understand and properly describe the decision-making process of childbearing in Kermanshah city.Methods: Adopting the grounded theory approach, this study was started with a purposive sampling and continued with theoretical sampling with maximum variation in terms of age, gender and number of children. In-depth interviews were carried out with 20 married women and 14 married men. The constant comparative method was used to analyze the data.Results: Individuals perceived certain needs in their lives. If a person believed that childbearing would reduce or fulfill these needs, then the childbearing demand will develop. Attitude to childbearing consequences and perceived norms were reasons for perceived childbearing needs. When the childbearing need was formed, a person plans to have or not have a child based on perception of capability in controlling current life conditions and in raising the child. If the person perceived that he/she could control the above conditions, “childbearing intention” was developed and if he/she considered the degree of control to be inappropriate, he/she would employ the strategy of childbearing avoidance and display the appropriate behavior according to this decision-making process.Conclusion: We found that child bearing is not an accidental phenomenon; rather, it is a rational choice. The childbearing decision-making is a process on the basis of satisfying some needs.

Objective (s): Several psychological and behavioral factors might affect intention to continue using oral contraceptives pill (OCP). Understanding and knowledge of these factors are practical strategy to increase intention of continuing use of OCP and improve women’s health. The aim of this study was to investigate the effect of self- efficacy (SE) and perceived behavioral control (PBC) in predicting intention to continue OCP use.Methods: This was a cross-sectional study of 180 women aged 15-49 years old new users of low dose (LD) pills attending family planning centers in Ahwaz, Iran. Data were collected via face-to-face interviews using a structured questionnaire and analyzed by SPSS 16 and LISREL 8.80. Perfroming a confirmatory analysis we compared the optimized model with the original model.Results: Both models showed a good fit for the data, but the optimized model [SE (X2/df) = 1.47 P= 0.0001 RMSEA=0.059 AIC=324] had a better fit than the original model [PBC (X2/df) = 1.62 P= 0.0001 RMSEA=0.068 AIC=361]. Also the optimized model can predict 35% of intention while the original model predicted 24% of intention.Conclusion: The findings suggerst that in educational programs based on theory of planned behavior (TPB) to increase the intention of continuation of using OCP, self-efficacy is superior to perceived behavioral control.

Objective (s): This study aimed to determine the value of Health Belief Model in predicting preventive behaviors of occupational accidents among building workers.Methods: The present study was a descriptive study of a random sample of 176 building workers in Mashhad, Iran. The study investigated the relationship between health belief model variables and occupational accidents in order to prevent injuries among building workers. The data were collected using two questionnaires including questions on demographic and the model structures.Results: The results showed significant correlation between preventive behaviors of occupational accidents and perceived benefits (p<0.05 & r= 0.319), perceived barriers (p<0.05 & r= - 0.26), perceived threat (p<0.05 & r= 0.60), cues to action (p<0.05 & r= 0.26), and self-efficacy (p<0.05 & r= 0.42). The regression analysis revealed that the model worked extremely well. Indeed, the independent variables accounted for 41.7% of the variance in behavior. The perceived threat and self-efficacy had the most influential role in the prediction.Conclusion: According to the results and due to the significant relationship between perceived threat and function, educational programs is recommended based on the health belief model to enhance the sensitivity and perceived intensity of the workers with emphasis on increasing self-efficacy.

Objective (s): To evaluate the psychometric properties of the Persian version of Work Ability Index questionnaire (WAI).Methods: In this methodological study, a sample of nurses and healthcare staff aged 40 years and above working in educational hospitals in Ahvaz (236 workers) in 2010, completed the questionnaire. Forward-backward method was applied to translate the questionnaire from English into Persian. The psychometric properties of Persian version of the WAI were assessed using the fallowing tests: Internal consistency and test-retest analysis (to test reliability), exploratory factor analysis, discriminant validity and convergent validity by determining the correlation between the Persian version of Short Form Health Survey (SF-36) and WAI score.Results: The Cronbach’s alpha coefficient was estimated to be 0.79 and the ICC was 0.83. Factor analysis indicated three factors: self-perceived work ability (24.5% of the variance), mental resources (22.23% of the variance), and presence of disease and health related limitation (18.55% of the variance). Statistical tests showed that the questionnaire was capable of discriminating two groups of employees who had different levels of sick leave. Convergent validity analysis showed that the instrument significantly correlated with all dimensions of Persian version of SF-36. Item-scale correlation corrected for overlap showed the items had a good correlation except for item.Conclusion: The finding showed that the Persian version of Work Ability Index is a reliable and valid measure of work ability and can be used both in research and practice.